A 35-year-old patient has been admitted to a hospital for pain in the left sternoclavicular and knee joints, lumbar area. The disease has an acute character and is accompanied by fever up to 38oC. Objectively: the left sternoclavicular and knee joints are swollen and painful. In blood: WBCs - 9, 5x109/l, ESR - 40 mm/h, CRP - 1,5 millimole/l, fibrinogen - 4,8 g/l, uric acid - 0,28 millimole/l. Examination of the urethra scrapings reveals chlamydia. What is the most likely diagnosis?

Correct Answer: A

Rationale: The most likely diagnosis is Reiter's syndrome. This is suggested by the presence of joint pain, fever, elevated ESR and CRP levels, and chlamydia infection. Reiter's syndrome is a reactive arthritis triggered by an infection elsewhere in the body, such as chlamydia. The patient's symptoms of joint pain and swelling, along with the positive chlamydia test, support this diagnosis. Rheumatic arthritis (Choice B) is not associated with chlamydia infection, making it less likely. Gout (Choice C) typically presents with elevated uric acid levels, which are normal in this case. Bechterew's disease (Choice D) primarily affects the spine and sacroiliac joints, not the sternoclavicular and knee joints as seen in this patient.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C (Nystatin) is the correct answer: 1. Nystatin is an antifungal medication specifically effective against Candida infections. 2. Candida is a type of fungus, not a bacteria targeted by penicillins (choice A) or cephalosporins (choice B). 3. Nystatin works by disrupting the fungal cell membrane, leading to its death. 4. Choice D (None of the above) is incorrect as Nystatin is a suitable treatment option for Candida infections.

Correct Answer: A

Rationale: The most likely diagnosis is A: Leptospirosis. Leptospirosis is caused by the spirochete Leptospira interrogans and is commonly transmitted through contact with water contaminated by animal urine, such as in this case of fishing. The symptoms described match those of leptospirosis, including high fever, headache, muscle pain, jaundice, hemorrhagic rash, and bloody urine. The calf muscle pain is a characteristic symptom of leptospirosis known as "Weil's disease." Yersiniosis (B) typically presents with abdominal symptoms, Salmonellosis (C) with gastrointestinal symptoms, and Brucellosis (D) with flu-like symptoms. Therefore, based on the symptoms and history provided, Leptospirosis is the most likely diagnosis.

Correct Answer: A

Rationale: Rationale: 1. Spore-forming, Gram-positive rods: Characteristics shared by Clostridium and Bacillus. 2. Motile and gas production in nutrient broth: Clostridium perfringens is motile and produces gas, distinguishing it from Bacillus species. 3. Clostridium perfringens causes gas gangrene, correlating with gas production. 4. Bacillus anthracis causes anthrax, not related to wound infections. 5. Clostridium tetani causes tetanus, not associated with gas production. 6. Bacillus cereus causes food poisoning, not commonly associated with wound infections. Summary: - A is correct (Clostridium perfringens) due to motility, gas production, and wound infection correlation. - B (Bacillus anthracis) causes anthrax, not wound infections. - C (Clostridium tetani) causes tetanus, not gas production. - D (B

Correct Answer: A

Rationale: The most likely diagnosis is Reiter's syndrome. This is suggested by the presence of joint pain, fever, elevated ESR and CRP levels, and chlamydia infection. Reiter's syndrome is a reactive arthritis triggered by an infection elsewhere in the body, such as chlamydia. The patient's symptoms of joint pain and swelling, along with the positive chlamydia test, support this diagnosis. Rheumatic arthritis (Choice B) is not associated with chlamydia infection, making it less likely. Gout (Choice C) typically presents with elevated uric acid levels, which are normal in this case. Bechterew's disease (Choice D) primarily affects the spine and sacroiliac joints, not the sternoclavicular and knee joints as seen in this patient.

Correct Answer: A

Rationale: The correct answer is A: Delayed-type hypersensitivity. The Mantoux test is a type IV hypersensitivity reaction, which is also known as delayed-type hypersensitivity. This reaction typically occurs 48-72 hours after exposure to an antigen, such as tuberculin in this case. The focal skin hardening and redness that appeared 60 hours after tuberculin introduction align with the timeline and characteristics of a delayed-type hypersensitivity reaction. Summary: - Choice A (Delayed-type hypersensitivity): Correct, as explained above. - Choice B (Immune complex-mediated hypersensitivity): Incorrect, as this reaction involves immune complexes and typically presents with tissue damage and inflammation. - Choice C (Complement-mediated cytotoxic hypersensitivity): Incorrect, as this reaction involves the activation of complement proteins leading to cell lysis. - Choice D (Immediate hypersensitivity): Incorrect, as this reaction, such as in allergies, occurs within minutes to hours of exposure to an antigen and involves IgE-mediated mast

Correct Answer: D

Rationale: The correct answer is D: Rubella virus. Rubella virus does not belong to the family Paramyxoviridae because it belongs to the Togaviridae family. The other choices, A (Measles virus), B (Respiratory syncytial virus), and C (Mumps virus) are all members of the Paramyxoviridae family. This classification is based on the genetic and structural characteristics of the viruses. Rubella virus is distinct in its genetic composition and replication cycle compared to the Paramyxoviridae family, making it the correct choice.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Mumps is a contagious disease transmitted through air droplets and direct contact. 2. The correct answer is A because mumps can infect both humans and animals. 3. Choice B is incorrect as mumps is vaccine-preventable. 4. Choice C is correct as mumps is highly contagious. 5. Choice D is accurate as mumps is transmitted via air droplets and direct contact. Summary: The correct answer is A because mumps can infect both humans and animals, making it untrue that only humans can be infected. Choices B, C, and D are incorrect as mumps is vaccine-preventable, highly contagious, and transmitted through air droplets and direct contact.

Correct Answer: B

Rationale: The correct answer is B: Bergey's Manual of Systematic Bacteriology. This manual is a comprehensive and authoritative resource specifically dedicated to bacterial taxonomy, classification, and identification. It provides detailed descriptions and classification schemes for bacteria, aiding in accurate identification and understanding of bacterial species. Gray's Anatomy (choice A) focuses on human anatomy, the WHO Manual (choice C) focuses on global health guidelines, and Darwin's Origin of Species (choice D) discusses evolution and natural selection, none of which are specialized taxonomic resources for bacteria.